A.P. Shket, E.V. Vasilevich, A.A. Komarovski, S.I. Kozlov, O.I. Kozlov, V.A. Tokunov, A.A. Khadanovich, Y.A. Selyn
In cardiac surgery departments, repeated operations are increasingly performed in patients who have undergone valve correction or coronary bypass surgery in the past. The operational risk in this group of patients is much higher than in the group of primary operations, and is due to the adhesive process, the risk of re-access to the heart, various anatomical and pathological scenarios of pathology. A clinical case of a 47-year-old patient is presented. Primary surgery was performed in 2006 for aortic stenosis and aneurysm of the ascending aorta. On the second operation, the separation of the conduit of the ascending aorta and aortic valve, the complete separation of both ostiums of the coronary arteries with the formation of a false aneurysm of the ascending aorta was revealed. The patient underwent a replacement of the aortic valve, ascending aorta, the left coronary artery reimplantation, CABG to RCA. This case is of great interest due to the extremely rare occurrence of such a variant of pathology.
keywords: aortic valve, reimplantation, false aneurysm of the ascending aorta

for references: A. Shket, E. Vasilevich, A. Komarovski, S. Kozlov, O. Kozlov, V. Tokunov, A. Khadanovich, Y. Selyn. A case of complete detachment of the conduit of the ascending aorta and aortic valve. Neotlozhnaya kardiologiya i kardioovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2019, vol. 3, no. 1, pp. 559–562

1. Luciani N., De Geest R., Anselmi A., Glieca F., De Paulis S., Possati G. Results of reoperation on the aortic root and the ascending aorta. Ann Thorac Surg, 2011, vol. 92, № 3, pp. 898–903. doi: 10.1016/j.athoracsur.2011.04.116.
2. David T.E., Feindel C.M., Ivanov J., Armstrong S. Aortic root replacement in patients with previous heart surgery. J Card Surg, 2004, vol. 19, № 4, pp. 325–328.
3. Pacini D., Di Marco L., Loforte A., Angeli E., Dell’Amore A., Bergonzini M., Di Bartolomeo R. Reoperations on the ascending aorta andaortic root. Early and late results? J Cardiovasc Surg, 2005, vol. 46, № 5, pp. 491–498.
4. Ostrovskiy Yu.P. Hirurgiya serdza [Heart surgery]. Мoscow, Med. Lit., 2007, 576 p. (in Russian).
5. Orlovskiy P.I., Grizenko V.V., Yuchnev A.D., Evdokimov S.V., Gavrilenkov V.I. Iskusstvennyie klapanyi serdza [Artificial heart valves]. Мoscow, ZAO «OLMA Media Grupp», 2007, 448 p. (in Russian).
6. Shrestha M., Khaladj N., Baraki H., Ahmad A., Koigeldiyev N., Pichlmaier M., Haverich A., Hagl C. Aortic Root Reoperation: A Technical Challenge. J Heart Valve Dis, 2010, vol. 19, № 2, pp. 177–181.
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